Ringworm on the head and scalp

Scalp ringworm may begin as a small area of scale before spreading across nearby skin. Possible findings include itch, redness, flaky or thick scale, tenderness, black dots where hairs have broken, or smooth-looking gaps in the hair. Some people develop a soft, swollen area with fluid or pus; this stronger inflammatory form needs prompt attention. The scalp may be affected without a classic ring-shaped rash. A clinician can distinguish it from dandruff and other causes of scalp scaling by examining the skin and hair.

Arrange an appointment for a new patch of scalp scale with hair breakage. Scalp infection often requires an oral antifungal medicine because fungi can live inside hair shafts. A medicated shampoo may reduce spores on the surface and lower spread, but it is not a substitute for the prescribed treatment. Keep combs, brushes, towels, hats, and pillowcases separate, wash them appropriately, and avoid sharing them. Check close contacts and household pets with professional guidance. Do not pick at crusts or use strong chemical relaxers while the scalp is sore.

Contact a clinician promptly for increasing pain, swelling, pus, extensive crusts, fever, or rapidly spreading inflammation. These changes can signal a more active response that may threaten follicles. Rebook an assessment if treatment causes a reaction or if new areas appear. Seek urgent help for facial swelling, eye symptoms, or feeling severely unwell.

Ask whether testing is needed, which medicine is suitable for scalp infection, whether shampoo should be added, and how to clean or replace shared hair items. Ask when follow-up should happen and what changes would suggest the infection is not clearing.